When I first started reading this book, I though that Kirsten M.F. Beyer might just be slipping a bit. The overly long memorial service, the pages spent with farewells and Janeway's issues and psychosis felt forced.
But by time I finished my confidence in my favorite Star Trek writer (sorry David Mack) had been restored.

Highlights

Characters.

Kirsten NAILS every single Voyager character. She just gets them. I wonder if she listens to just their dialogue before she starts writing, because if you read their words out loud, the pacing and diction is perfect. The Doctor in particular is well written. In addition to getting the characters right, she makes you care about them and their problems. As a father of a small child, the scenes between Tom and B'lanna were beautifully authentic and poignant. The "modification" to the Doctor was well conceived idea, and I look forward to seeing how she integrates the consequences of that modification in future novels. She even manages to give the blandest and hardest character to write - Harry Kim - some substance and life. In addition to THAT, she also has created some of the most interesting "new" characters, Commander O'Donnell, Hugh Cambridge, and the Tamarian Dr. Sharak and she does a fine job expanding on their characters here.
I wish that TPTB could find some way to get Tuvok on Voyager as I would love to see KMFB incorporate him into her stories.

Story

Although this novel was in some ways a Part II of the Eternal Tide, the Ark planet, the wave form creatures, the subtle menace of the "villains of the Delta Quadrant" alliance, the story of Axum, all were well done, and highlighted another of KMFB's strengths: she can write an excellent serialized story. She weaves in various elements and gets you excited about the next novel, all while telling a complete and whole story within the current novel. That is very hard to do. There are so many very interesting threads in this novel that I am eager to see how they play out. It is obvious that KMFB has spent some time trying to contemplate what would happen to the Delta Quadrant and its balance of power once the Borg were no longer a threat, and I like the conclusions she seems to have made. Very, very cool.

Lowlights

Janeway's navel gazing.

I know that it is appropriate and reasonable to discuss the life altering events that Janeway has experienced, and that Janeway needed to be able to find some way to process the events that no other Star Trek character could possibly understand, but the counseling sessions and emotional discovery seemed to drag on and on, and then be abruptly "fixed" by Counselor Jane Austen.

Julia Paris' decision.
The pending custody hearings creates dramatic tension, but I think that it unnecessarily complicates B'lanna and Tom's story, and it just feels wrong, almost contrived.

The mysterious Starfleet bad guys.

This is a minor quibble, but when bad guys are given names like "The Commander" and are revealed in an epilogue, it just feels a bit silly. I felt that the revelation of Axum's torture, the cold and clinical way that the "bad" doctors addressed Axum, and the "reporting to the superiors", along with other hints adequately revealed that something funky was going on. The epilogue was just a bit much.

Overall, this book was another excellent addition to the KMFB collection, and I eagerly await her next novel. Thanks Kirsten for taking one of the weakest TV series and turning it into one of the strongest, if not THE strongest, novel series in the TrekLit universe.